Should respiratory muscle training be part of the treatment of Parkinson’s disease? A systematic review of randomized controlled trials

2019 ◽  
Vol 34 (4) ◽  
pp. 429-437
Author(s):  
Miguel Ángel Rodríguez ◽  
Irene Crespo ◽  
Miguel del Valle ◽  
Hugo Olmedillas
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Randomized Controlled Trials ◽  
Respiratory Muscle ◽  
Respiratory Muscle Training ◽  
Controlled Trials ◽  
Muscle Training ◽  
Swallowing Function ◽  
Randomized Controlled ◽  
Training Programmes

Objective: To determine the effectiveness of respiratory muscle training in persons with Parkinson’s disease. Data sources: PubMed/MEDLINE, EMBASE, Web of Science, Scopus and PEDro electronic databases were searched until 15 November 2019. Reference lists of included studies were hand-searched. Methods: Randomized controlled trials assessing the effects of respiratory muscle training programmes (both inspiratory and expiratory) in patients with Parkinson’s disease were included. Two reviewers independently identified eligible studies and extracted data. Method quality was appraised with the PEDro scale. Results: Five papers including three randomized controlled trials with a total of 111 patients were identified. Method appraisal showed a mean score of 5 in the PEDro scale. One study analysed inspiratory muscle training, one expiratory muscle training and two established a comparison between both of them. Statistically positive results were found in maximal inspiratory pressure ( P < 0.05 and d = 0.76), maximal expiratory pressure ( P < 0.01 and d = 1.40), perception of dyspnoea ( P < 0.01), swallowing function ( d = 0.55) and phonatory measures, without significant differences in spirometric indices. Conclusions: Respiratory muscle training may be an effective alternative for improving respiratory muscle strength, swallowing function and phonatory parameters in subjects with Parkinson’s disease. Nevertheless, the lack of primary studies about this type of training prevents obtaining robust evidence.

scholarly journals Additional Physical Interventions to Conventional Physical Therapy in Parkinson’s Disease: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

2020 ◽  
Vol 9 (4) ◽  
pp. 1038 ◽  
Author(s):  
Ruben D. Hidalgo-Agudo ◽  
David Lucena-Anton ◽  
Carlos Luque-Moreno ◽  
Alberto Marcos Heredia-Rizo ◽  
Jose A. Moral-Munoz
Keyword(s):  
Systematic Review ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Physical Therapy ◽  
Randomized Controlled Trials ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Balance Confidence ◽  
Randomized Controlled

Parkinson’s disease (PD) represents the second most common neurodegenerative disease. Currently, conventional physical therapy is complemented by additional physical interventions with recreational components, improving different motor conditions in people with PD. This review aims to evaluate the effectiveness of additional physical interventions to conventional physical therapy in Parkinson’s disease. A systematic review and meta-analysis of randomized controlled trials were performed. The literature search was conducted in PubMed, Physiotherapy Evidence Database (PEDro), Scopus, SciELO and Web of Science. The PEDro scale was used to evaluate the methodological quality of the studies. A total of 11 randomized controlled trials were included in this review. Five of them contributed information to the meta-analysis. The statistical analysis showed favorable results for dance-based therapy in motor balance: (Timed Up and Go: standardized mean difference (SMD) = −1.16; 95% Confidence Interval (CI):(−2.30 to −0.03); Berg Balance Scale: SMD = 4.05; 95%CI:(1.34 to 6.75)). Aquatic interventions showed favorable results in balance confidence (Activities-Specific Balance Confidence: SMD=10.10; 95%CI:(2.27 to 17.93)). The results obtained in this review highlight the potential benefit of dance-based therapy in functional balance for people with Parkinson’s disease, recommending its incorporation in clinical practice. Nonetheless, many aspects require clarification through further research and high-quality studies on this subject.

scholarly journals Detraining Effect on Pulmonary and Cardiovascular Autonomic Function and Functional Outcomes in Patients With Parkinson's Disease After Respiratory Muscle Training: An 18-Month Follow-Up Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Chih-Cheng Huang ◽  
Yun-Ru Lai ◽  
Fu-An Wu ◽  
Nai-Ying Kuo ◽  
Ben-Chung Cheng ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Pulmonary Function ◽  
Functional Outcomes ◽  
Respiratory Muscle ◽  
Autonomic Function ◽  
Clinical Severity ◽  
Respiratory Muscle Training ◽  
Muscle Training ◽  
Cardiovascular Autonomic Function

Background: The effect of 3-month respiratory muscle training (RMT) on pulmonary and autonomic function and functional outcomes has been demonstrated in patients with Parkinson's disease (PD); however, there is a paucity of information on the durability of the training effect. In this study, we monitored the pulmonary and cardiovascular autonomic function and clinical severity scales until 18 months after the cessation of RMT to elucidate the detraining effect after RMT.Methods: All patients with PD receiving RMT were assessed with clinical severity scales as well as pulmonary and autonomic function tests at four different stages (baseline on enrollment, immediately after 3 months of RMT, and 6 and 18 months after cessation of RMT). A control group of PD patients who did not receive RMT was also recruited for comparison. Pulmonary function parameters, including forced vital capacity (FVC), forced expiratory volume in one second (FEV1), maximum inspiratory pressure (MIP), and maximum expiratory pressure (MEP), were assessed. Cardiovascular autonomic function was assessed using measures including heart rate response to deep breathing (HRDB), Valsalva ratio, and baroreflex sensitivity. Clinical severity scores were also measured using the Hoehn and Yahr staging and the Unified Parkinson's Disease Rating Scale (UPDRS).Results: The results showed significant improvements in MIP, MEP, HRDB, and UPDRS immediately after RMT. Despite some decay, the improvements in pulmonary function (MIP and MEP) and functional outcomes (UPDRS) remained significant until 6 months of detraining (9 months after enrollment). However, the improvement in cardiovascular autonomic function (HRDB) was reversed after 6 months of detraining.Conclusions: Based on these findings, we recommend that RMT may be repeated after at least 6 months after previous session (9 months after enrollment) for patients with PD to maintain optimal therapeutic effects.

Cardiovascular Adverse Events Reported in Placebo Arm of Randomized Controlled Trials in Parkinson’s Disease

2020 ◽  
Vol 10 (2) ◽  
pp. 641-651
Author(s):  
Mariana Alves ◽  
Daniel Caldeira ◽  
Miguel Leal Rato ◽  
Gonçalo S. Duarte ◽  
Afonso N. Ferreira ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Adverse Events ◽  
Randomized Controlled Trials ◽  
Controlled Trials ◽  
Randomized Controlled

scholarly journals Simultaneously Improved Pulmonary and Cardiovascular Autonomic Function and Short-Term Functional Outcomes in Patients with Parkinson’s Disease after Respiratory Muscle Training

2020 ◽  
Vol 9 (2) ◽  
pp. 316
Author(s):  
Chih-Cheng Huang ◽  
Yun-Ru Lai ◽  
Fu-An Wu ◽  
Nai-Ying Kuo ◽  
Yuh-Chyn Tsai ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Pulmonary Function ◽  
Functional Outcomes ◽  
Respiratory Muscle ◽  
Autonomic Function ◽  
Respiratory Muscle Training ◽  
Muscle Training ◽  
Short Term ◽  
Cardiovascular Autonomic Function

Both pulmonary function and autonomic function are impaired in patients with Parkinson’s diseases (PD). This study tested the hypothesis that respiratory muscle training (RMT) can not only improve pulmonary function, but also simultaneously improve cardiovascular autonomic function and short-term functional outcomes in patients with PD. Pulmonary function was measured by the forced vital capacity (FVC), forced expiratory volume in one second (FEV1), maximum inspiratory pressures (MIP), and maximum expiratory pressures (MEP). Cardiovascular autonomic function was measured by the heart rate response to deep breathing (HRDB), Valsalva ratio, baroreflex sensitivity, and spectral analysis. The functional and severity scores were measured by the Hoehn and Yahr stage and Unified Parkinson’s Disease Rating Scale (UPDRS). These measures were evaluated in patients with PD before and after 3 months of RMT, compared with a control group of PD patients without RMT. The results showed significant improvement of clinical scores (total UPDRS and UPDRS I, II and III) after RMT (p < 0.0001). Concerning pulmonary function, the parameters of MIP and MEP improved significantly. The parameters of cardiovascular function also improved after RMT, although only HRDB reached statistical significance. Based on the results of our study, RMT can not only improve both pulmonary and cardiovascular autonomic function, but can also improve short-term functional outcomes in patients with PD.

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